Living Situation of Juveniles After Secure Residential Treatment: Exploring the Role of Family Centeredness, Child, and Family Factors.

To promote the return of juveniles to a home-like environment (e.g. living with (foster)parents) after secure residential treatment (SRT), it is important to know which factors are related to this outcome. The current study examined which characteristics of the juvenile, family, and SRT, including family centeredness and use of systemic interventions, are related to the living situation after discharge. For 259 juveniles (mean age 15.82 years, 127 girls) in SRT and their parents, questionnaires were administered at admission, discharge, and 6-months follow-up. Furthermore, information about the living situation before and after SRT was gathered. Higher likelihood of living in a home-like setting after SRT correlated with more furlough moments with parents, receiving a systemic intervention, and a shorter duration of the SRT. Systemic interventions during SRT and spending furlough moments with parents may have a positive impact on returning to a home-like situation after SRT for juveniles.

Treatment Fidelity during Therapist Initial Training is related to Subsequent Effectiveness of Parent Management Training-Oregon Model.

The present study examined the association between treatment fidelity during therapist initial training and subsequent treatment outcome of Parent Management Training - Oregon model (PMTO) in The Netherlands. Clinically referred children (N = 86) aged 4 to 11 years and their parents received PMTO and were assessed at four time points: at baseline, and after 6, 12, and 18 months. Difference scores between baseline and follow-up assessments of externalizing behavior problems, parenting practices, and parental psychopathology and parents' overall ratings of working alliance, were correlated with treatment fidelity scores measured prior to the intervention. Furthermore, differences in therapists' fidelity scores between treatment completers and drop-outs were examined. Results showed that higher fidelity scores of PMTO therapists during initial training were associated with larger improvements in externalizing behavior, parenting practices, and parental psychopathology, especially after 18 months. In addition, parents who completed the treatment had a significantly more adherent therapist than families who dropped out. However, the correlations between treatment fidelity and working alliance were non-significant. These findings indicate that therapists' high adherence to the PMTO treatment principles during initial training decreases the chance of treatment drop-out and positively affects the longterm effectiveness of PMTO.